PTSD and Workers’ Compensation

According to the National Center for Post Traumatic Stress Disorder (NCPTSD), some 7.8 percent of Americans will experience post traumatic stress disorder (PTSD) at some point in their lives. How does PTSD impact an employer’s workers’ compensation program?

PTSD is a psychological syndrome that can affect a person of any age. A person can develop PTSD after living through or seeing a traumatic event, such as war, a hurricane, sexual assault, physical abuse or a bad accident. PTSD makes you feel stressed and afraid after the danger is over. It affects your life and the people around you.

• Flashbacks, or feeling like the event is happening again
• Trouble sleeping or nightmares
• Feeling alone
• Angry outbursts
• Feeling worried, guilty or sad.

PTSD starts at different times for different people. Signs of PTSD may start soon after a frightening event and then continue. Other people develop new or more severe signs months or even years later. PTSD can happen to anyone, even children.

How Can PTSD Affect Your Workers’ Compensation?

An employee with PTSD is more likely to suffer mental stress from a workplace incident than other employees. However, PTSD differs from other “co-morbid” conditions, such as obesity, a prior injury or seizures, which make a person more prone to accident or health problems. Unlike those other conditions, PTSD is not easily visible and often undiagnosed.

Employers take their employees as they are, past experiences and all. That doesn’t mean that you have to p

ay for their past injuries. But if your worker has an injury that stems from work, your workers’ compensation would cover it, even if he had a condition that made him more prone to injury. For example, let’s say an overweight warehouse worker developed knee problems from too much bending. If he could prove the job caused his injury, your workers’ compensation would have to cover the injury—even if his obesity made him more prone to joint problems. Or if a pregnant woman developed carpal tunnel syndrome, her injury might be covered, even if pregnancy increases the risk of developing carpal tunnel syndrome.

Sometimes physical trauma, such as an assault or injury, can trigger episodes of PTSD. Sometimes they happen due to mental stimulus, such as harassment or other stressful events with no physical injury.
In some states, workers’ compensation only covers mental stress claims, including PTSD, if the stress results from a physical injury. Other states will compensate so-called “mental-mental” claims. According to Thomas A. Robinson, JD, states that do not compensate for mental-mental claims, including PTSD, include Alabama, Arkansas, Connecticut, Florida, Georgia, Idaho, Kentucky, Minnesota, Montana, Nevada, New Hampshire, Ohio, Oklahoma and Wyoming. Other states might compensate these claims, but might put conditions on them. For example, some pay mental-mental claims only if they arise from an unusual or sudden mental stimulus.
(Source: “The Post-Traumatic Stress Disorder Dilemma for Workers’ Compensation Claims,” LexisNexis Legal Newsroom Workers Compensation Law, June 20, 2014.)

Workplace Trauma

If a traumatic or violent event happens at work, employees who suffer immediate emotional stress may have claims that would be denied under normal work conditions. Some state regulations explicitly address violence, and in other states, court rulings have established precedents for dealing with claims that stem from violent acts.

Handling a Stress Claim

If an employee files a stress or mental injury workers’ compensation claim, follow your usual procedures to gather initial information. With a stress claim, the employee’s overall mental health and his or her personal life may become relevant. This is a sensitive area that your workers’ compensation insurer should handle.

Whether an employee’s stress is caused by workplace problems or personal ones, his or her performance at work may suffer. Stressed-out office employees lose effectiveness, and workers become more prone to injuries when they feel tired or stressed, leading to more bodily injury claims, lost time and higher comp rates.

One EAP provider, ESI, reports that 20 percent of employees have a major personal problem that results in an average of three weeks of lost productivity every year. An employee assistance program (EAP) can help workers deal with emotional and psychological problems that affect work performance and increase the chances of accidents and injuries.